Tuesday, October 25, 2016

Early Identification Programs Show Urban Poor More Likely to Meet Psychosis Criteria

Individuals from deprived and urban communities appear most likely to meet criteria for first-episode psychosis (FEP) among those referred to early identification programs in the eastern region of England, according to an epidemiological analysis in AJP in Advance.

The findings could be used to inform the provision of effective early intervention services for psychosis in the United States and other areas where early identification is less established but gaining traction, according to researchers from several English institutions and agencies.

The researchers identified all new first-episode psychosis cases of individuals aged 16 to 35 years old presenting to early intervention psychosis services in the East of England. Importantly, they found that those most likely to meet criteria for FEP were poorer, younger males from deprived and densely populated neighborhoods. For instance, 68.7% of those between the ages of 16 and 25 met the criteria, compared with 31.3% of those over age 25. Additionally, 55.6% of referrals who met the criteria for FEP were either long-term unemployed or “long-term sick or disabled,” compared with 22.4% of those who were employed. And 52.1% resided in the neighborhoods with the highest population density.

The findings point to possible environmental factors that may influence the incidence of schizophrenia, but the researchers said it is difficult to rule out other possibly confounding influences, relevant to psychosis, that may aggregate among lower sociodemographic populations.

“Further longitudinal studies are required to disentangle the potential role of social causation from [other confounding factors],” the researchers wrote. “Although we could not establish causation directly, our results demonstrate that our most deprived and urban communities shoulder a disproportionate burden of psychosis morbidity at the population level. This should be used to inform the provision of effective early intervention services for psychosis.”

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